老年患者骨科手术风险性预测及相关因素的前瞻性研究

目的　通过对老年骨科患者生活能力水平与手术并发症之间关系的研究 ,为老年骨科患者提供最佳的手术方案 ,从而减少围手术期致险事件的发生。方法　将 189例 6 0岁以上的骨科患者随机分为研究组及对照组 ,对照组依据各脏器系统检验结果确定手术时机及手术种类 ,研究组则根据患者的生活能力水平确定所进行手术的种类。统计两组间围手术期并发症发生率及死亡率。结果　研究组出现各类并发症 11例 ,并发症发生率 12 .79% ,死亡 1例 ,死亡率 1.16 %。对照组出现各类并发症 5 0例 ,并发症发生率 4 8.5 4 % ,死亡 6例 ,死亡率 5 .83%。两组间并发症发生率及死亡率比较差异有显著性意义 (P<0 .0 5 )。结论　生活能力水平是评估老年人身体健康程度的最重要的指标 ,以此为依据选择老年人所需进行骨科手术的种类 ,可以明显降低老年骨科患者围手术期的并发症发生率及死亡率。

Prospective Studies on the Relationship of the Activities of Daily Living and the Orthopedic Operative Complications in the Aged

Objective To study the relationship of the activiti es of daily living(ADL)and the postoperative complications in the aged and provide the best operation protocal and decrease the risk of operation. Methods 189 patients with orthopedic in aged were divided into the control group (n=103)and the investigate group(n=86). The control group according to each dirty machine system examination result decide the surgical operation opportune and the surgical operation categories, and the investigate group according to the ADL.The postoperative complications and mortalities were compared. Results The investigate group complications was 11 cases(12.79%), mortality was 1 case(1.16%); the control group complications was 50 cases(48.54%), mortality was 6 cases(5.83%). There were significant difference among them( P <0.05). Conclusion The ADL is the most important index in valuation of healthy degree in the aged. According to the ADL decide the surgical operation opportune and the surgical operation categories, can obviously lower the complications rate and death rates in aged orthopedic patients.